NHS North of Tyne: Equality Impact Assessment - New Emergency Care Facility

We were commissioned by NHS North of Tyne to carry out an Equality Impact Assessment on the development of a new emergency care facility, with the aim of identifying and exploring the risks and issues relating to equality and considering how the opportunities to promote equality through the proposed development could be maximised.

The proposal was put forward by Northumbria Healthcare NHS Foundation Trust and comprised three elements:

• The development of a new emergency care hospital off the A19 in the vicinity of Moor Farm roundabout;
• Improvements at North Tyneside and Wansbeck General hospitals; and
• Community hospital developments at Berwick and Haltwhistle.

The proposal is intended to benefit everyone living in the areas of North Tyneside and Northumberland, through the provision of improved emergency care. Northumbria Healthcare had identified a need for specialist clinicians to be available earlier in care pathways and believed that this would improve both patient experience and clinical outcomes in emergency admissions.

NHS North of Tyne led public consultation on the proposal which ran for three months. The feedback showed that, overall, there was considerable support for the concept of a dedicated emergency care hospital but that there were a number of concerns. The most controversial issue was the proposed location, particularly for people living in the north and west of Northumberland. There were also questions about access and the lack of public transport.

The EqIA was commissioned to address the concerns raised during the public consultation and inform decision making regarding the development of the emergency hospital. As with any EqIA, we also assessed whether NHS North of Tyne is complying with the requirements of the relevant equalities legislation in relation to this decision and the decision-making process, identified opportunities to promote equality, highlighted risks to equality and suggested ways of mitigating those risks.

In addition to the consultation data and the original proposals, we reviewed the accessibility report produced by AECOM (transport and engineering consultant), a number of strategic documents, workforce monitoring data, local and regional demographics, health inequalities data, travel information and maps.

Our report focused on the following areas:

• Geography and demography;
• The choice of location (including the methodology employed);
• Transport – existing public transport and road networks to Cramlington;
• Findings of the consultation relevant to the equality strands;
• National and local evidence about relevant health inequalities; and
• Workforce monitoring data from general hospitals which might be affected.

We concluded that the clinical case for the new hospital seemed clear and if the health outcomes are as expected then this new facility will help to reduce avoidable deaths in the area and, therefore, help to reduce health inequalities. One of the key issues which need to be resolved is public transport. This will affect a wide range of people and could impact negatively on people from some equality strands. However, it should be possible to mitigate this risk through continued liaison with the relevant transport authorities. We also concluded that the proposed site was the most equitable option, based on population concentration and journey time analysis.

On the whole, the development of a new hospital provides a wonderful opportunity to get things right and embed equalities from the start. It will be possible to ensure that the building is accessible and provides a pleasant environment for patients, staff and visitors. There will also be the opportunity to develop a workforce that is representative of the local community and ensure that equalities are embedded in HR and management policies.

Our report was considered by the Commissioning Board on 23 October 2009, together with the AECOM accessibility report, an internal update and supplementary clinical data. This resulted in a decision to approve the proposals subject to a number of conditions. These included a provision that Northumbria Healthcare NHS Foundation Trust continues to work on public transport, plus patient transport plans and facilities for relatives and carers and fully involve NHS North of Tyne and local people in their development.

We are delighted that we were commissioned by NHS North of Tyne on a project which could lead to significant improvements in health inequalities across the region.

Our final report can be viewed on the NHS North of Tyne website.